Colorectal
Liver Oligometastases: Upfront vs. Delayed Thermal Ablation
Leesburg,
VA, December 14, 2022—According
to an accepted manuscript published in ARRS’ American Journal of Roentgenology (AJR), upfront
ablation plus adjuvant systemic therapy improves progression-free survival
(PFS) of patients with colorectal liver oligometastases (CLOM) and low tumor
burden score (TBS), supporting ablation as an alternative to surgical
resection.
Clarifying that upfront thermal ablation
performed 2-4 weeks before starting systemic therapy achieved significantly
better PFS, compared with thermal ablation delayed 2-3 months after the star of
therapy, “the findings will help guide the optimal clinical implementation of
thermal ablation for patients with CLOM who are not candidates for surgical
resection,” wrote corresponding author Ping Liang, MD, PhD, from the
department of interventional ultrasound at Fifth Medical Center of Chinese PLA
General Hospital in Beijing.
Of 543 total patients
(346 men, 197 women; mean age, 58.1 years) with CLOM across nine institutions,
322 patients delayed thermal ablation, whereas 118 underwent thermal ablation
upfront—in combination with systemic therapy—between October 2009 and December
2020. Analyses included all patients using crude data, as well a patient subset
using propensity-score matching (PSM) for balanced baseline variables. Based on
number and size of liver metastases, patients were then classified as having a low
or high TBS. PFS was the primary outcome; secondary outcomes included overall
survival.
Ultimately, in this
multicenter retrospective study of patients with CLOM, after application of
PSM, median PFS was 1.1 years and 2.0 years in patients who underwent delayed
and upfront ablation, respectively, in combination with systemic therapy.
“In subgroup
analysis,” the authors of this AJR accepted
manuscript added, “the
difference between the two timings for thermal ablation was observed in
patients with low TBS, but not in patients with high TBS.”
An electronic supplement to this AJR
accepted manuscript is available here.
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first radiological society, the American Roentgen Ray Society (ARRS) remains dedicated to the advancement
of medicine through the profession of medical imaging and its allied sciences.
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MEDIA CONTACT:
Logan K. Young, PIO
44211 Slatestone Court
Leesburg, VA 20176
703-858-4332
lyoung@arrs.org